古老裂隙瘤的综合研究:探索组织形态多样性和诊断难题。

IF 0.9 Q4 ONCOLOGY
Rare Tumors Pub Date : 2024-09-19 eCollection Date: 2024-01-01 DOI:10.1177/20363613241274259
Chaithra Gowthuvalli Venkataramana, Soumya Gupta, Rakshatha Nayak, Sinchana Km, Sharada Rai, Ranjitha Rao
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引用次数: 0

摘要

背景:古神经分裂瘤是一种罕见的亚型神经分裂瘤,其特点是病程长、退行性变化明显。这些变化包括安东尼 A 型区的相对消失、血管周围透明化、出血、囊性坏死、钙化以及可模拟肉瘤多形性的非典型核的存在。这些组织学特征常常导致诊断上的困难,古老的裂隙瘤经常被误诊为恶性肿瘤。研究目的本研究旨在对古分裂瘤的组织形态学谱系进行全面评估。方法:采用回顾性分析方法,对对我们的三级医疗中心在 2017 年至 2023 年期间接收的 248 例神经分裂瘤病例进行了回顾性分析。在这些病例中,有 25 例被确定为古神经分裂瘤。在光镜下使用苏木精和伊红染色的石蜡包埋组织切片对退行性变化进行了广泛检查。检查结果患者年龄从 22 岁到 82 岁不等,性别分布几乎相等(12 名女性和 13 名男性)。肿瘤位于不同的解剖部位,包括前臂、大脑、腹部、腹膜后、硬膜内间隙、腰部和骨盆。肿瘤大小从 1.5 厘米到 11 厘米不等。组织学上,大多数病例表现为核不典型性、囊性改变、出血和梭形细胞,以及血管周围透明化、肌样改变、钙化和黄瘤样改变。免疫组化证实这些肿瘤来源于神经。结论识别继发性变化的多样性,以及显示白细胞和细胞纺锤形细胞排列的病灶区域的存在,对于准确诊断古神经分裂瘤至关重要。这项研究强调了组织形态学评估在区分这些良性肿瘤和恶性肿瘤方面的重要性,从而为适当的临床治疗策略提供指导。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Comprehensive study of ancient schwannoma: Exploring histomorphological diversity and diagnostic challenges.

Background: Ancient schwannoma is a rare subtype of schwannoma characterized by an extended duration of development and distinctive degenerative changes. These changes encompass relative loss of Antoni type A areas, perivascular hyalinization, hemorrhage, cystic necrosis, calcification, and the presence of atypical nuclei that can mimic sarcomatous pleomorphism. These histologic features often lead to diagnostic challenges, with ancient schwannomas frequently being misdiagnosed as malignant tumors. Objectives: This study aims to provide a comprehensive evaluation of the histomorphological spectrum observed in ancient schwannoma. Methods: A retrospective analysis was conducted on 248 schwannoma cases received at our tertiary health centre, spanning the years 2017 to 2023. Among these cases, 25 were identified as ancient schwannoma. Extensive examination of degenerative changes was performed using hematoxylin and eosin-stained paraffin-embedded tissue sections under light microscopy. Results: Patient ages ranged from 22 to 82 years, with a nearly equal distribution between genders (12 females and 13 males). Tumors were located in various anatomical sites including the forearm, brain, abdomen, retroperitoneum, intradural space, lumbar region, and pelvis. Tumor dimensions varied from 1.5 to 11 cm. Histologically, most cases exhibited nuclear atypia, cystic changes, hemorrhage, and siderophages, along with perivascular hyalinization, myxoid change, calcification, and xanthomatous change. Immunohistochemistry confirmed the neural origin of these tumors. Conclusion: Recognition of the diverse spectrum of secondary changes, coupled with the presence of focal areas showing paucicellular and cellular spindle cell arrangements, is crucial for the accurate diagnosis of ancient schwannoma. This study underscores the importance of histomorphological evaluation in distinguishing these benign tumors from malignant counterparts, thereby guiding appropriate clinical management strategies.

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Rare Tumors
Rare Tumors ONCOLOGY-
CiteScore
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